Individual provider Active NPI

Conrad Louis Trapp, D.C.

  • Chiropractor
  • Broken Arrow, OK
National Provider Identifier
1548320195
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3369 Issued in OK
Practice address
307 W Washington St
Broken Arrow, OK 74012-6448
Phone
(918) 449-9555
Fax
(918) 449-9559
NPI assigned
Dec 12, 2006
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3369 OK Primary

Addresses

Primary practice location

307 W Washington St
Broken Arrow, OK 74012-6448

Mailing address

307 W Washington St
Broken Arrow, OK 74012-6448
Phone (918) 449-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120409000593 OK Practitioner - Chiropractic 5294996856 Reassigns benefits to 1 organization
Practice locations: Broken Arrow, OK

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Trapp Spinal Care PLLCGroup PAC ID 3274834411, 2 clinicians

Practice addresses (Care Compare)

307 W Washington St
Broken Arrow, OK 74012-6448
Phone (918) 449-9555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3369OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Trapp Spinal Care, PLLC Chiropractor CurrentSince Sep 16, 2015 Accepting new patients

Locations

2017 S Elm Pl
Ste 100
Broken Arrow, OK 74012
Phone (918) 449-9555

307 W Washington St
Broken Arrow, OK 74012
Phone (918) 449-9555

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1548320195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 W WASHINGTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126448",
            "telephone_number": "918-449-9555",
            "fax_number": "918-449-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W WASHINGTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126448",
            "telephone_number": "918-449-9555",
            "fax_number": "918-449-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAPP",
        "first_name": "CONRAD",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.